Traumatic aortic rupture
| Traumatic aortic rupture | |
|---|---|
 |
|
| The aorta, shown in red | |
| Classification and external resources | |
| Specialty | emergency medicine |
| ICD-10 | S25.0, S35.0 |
| ICD-9-CM | 901.0, 902.0 |
| MeSH | D001019 |
Traumatic aortic rupture, also called traumatic aortic disruption or transection, is a condition in which the aorta, the largest artery in the body, is torn or ruptured. The condition is frequently fatal due to the profuse bleeding that results from the rupture. Since the aorta branches directly from the heart to supply blood to the rest of the body, the pressure within it is very great, and blood may be pumped out of a tear in the blood vessel very rapidly. This can quickly result in shock and death. Thus traumatic aortic rupture is a common killer in automotive accidents and other traumas, with up to 18% of deaths that occur in automobile collisions being related to the injury. In fact, aortic disruption due to blunt chest trauma is the second leading cause of injury death behind traumatic brain injury.
Aortic rupture can also be caused by non-traumatic mechanisms, particularly abdominal aortic aneurysm rupture.
The injury is usually caused by high speed impacts such as those that occur in vehicle collisions and serious falls. It may be due to different rates of deceleration of the heart and the aorta, which is in a fixed position.
By far the most common site for tearing in traumatic aortic rupture is the proximal descending aorta, near where the left subclavian artery branches off from the aorta. The tethering of the aorta by the ligamentum arteriosum makes the site prone to shearing forces during sudden deceleration.
A study of people who died after traumatic aortic rupture found that in 55–65% of cases the damage was at the aortic isthmus and in 10–14% it was in the ascending aorta or aortic arch. An angiogram will often show an irregular outpouching beyond the takeoff of the left subclavian artery at the aortic isthmus, representing an aortic pseudoaneurysm caused by the trauma. Damage can also be in the lower thoracic or abdominal aorta.
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Wikipedia